We carried out this announced inspection on 19 September 2017 under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. We planned the inspection to check whether the registered provider was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations. A CQC inspector, who was supported by a specialist dental adviser, led the inspection.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?

• Is it effective?

• Is it caring?

• Is it responsive to people’s needs?

• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

Are services safe?

We found that this practice was providing safe care in accordance with the relevant regulations.

Are services effective?

We found that this practice was providing effective care in accordance with the relevant regulations.

Are services caring?

We found that this practice was providing caring services in accordance with the relevant regulations.

Are services responsive?

We found that this practice was providing responsive care in accordance with the relevant regulations.

Are services well-led?

We found that this practice was providing well-led care in accordance with the relevant regulations.

Background

Aldeburgh Dental Practice is a well-established practice that provides mostly private dentistry to patients of all ages. The dental team consists of two dentists, a part-time hygienist/practice manager, two dental nurses and a receptionist. The practice has three treatment rooms and is open Mondays to Fridays from 8.30am to 5.30pm. There is portable ramp access for wheelchair users at the front of the building.

The practice is owned by an individual who is the principal dentist there. He has legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the practice is run.

During the inspection, we spoke with the principal dentist, the hygienist/practice manager, and a dental nurse. We looked at the practice’s policies and procedures, and other records about how the service was managed. We collected 16 comment cards filled in by patients prior to our inspection and spoke with one patient.

Our key findings were:

• We received many very positive comments from patients about the dental care they received and the staff who delivered it.

• The practice was clean and well maintained, and had infection control procedures that reflected published guidance.

• Staff knew how to deal with emergencies, although not all recommended life-saving equipment was available.

• The practice had systems to help them manage risk.

• Patients’ needs were assessed and care was planned and delivered in line with current best practice guidance from the National Institute for Health and Care Excellence (NICE) and other published guidance.

• Members of the dental team were up-to-date with their continuing professional development and were supported to meet the requirements of their professional registration.

• There was a clear leadership structure and staff felt supported and valued by the practice manager and owner. The practice proactively sought feedback from staff and patients, which it acted on.

There were areas where the provider could make improvements. They should

• Review the practice’s system for the recording, investigating and reviewing incidents or significant events with a view to preventing further occurrences and, ensuring that improvements are made as a result

• Review the practice’s protocols for the use of rubber dams for root canal treatment giving due regard to guidelines issued by the British Endodontic Society.

The purpose of this inspection was to check that improvements had been made following our last inspection of 14 August 2013 when we found concerns with regards to the safeguarding of people who used the service from abuse and requirements relating to workers. At this follow up inspection we found that improvements had been made.

During our inspection we spoke with the practice manager and dental hygienist. We also looked at staff training records. We saw that all staff had recently attended a training course in the safeguarding of vulnerable adults and children. We also saw that all staff had been trained in understanding the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DOLS) and its relevance to their profession.

We saw that the provider had improved their system for managing the recruitment and selection of staff. We looked at two staff files, one file viewed related to a member of staff recently employed by the service. The provider had updated their recruitment and selection of staff policy. We saw that staff files contained evidence of the interview process which included the questions asked at interview and a scoring system. This showed us how the provider had assessed the suitability of candidates to carry out the role they had been recruited into. We also saw that satisfactory pre-employment checks such as criminal records checks had been obtained.

We found that the Aldeburgh Dental Practice provided dental care according to the needs of people who used the service. Dental staff spoke with people to check if there were any changes in their medical condition from the previous treatment.

The people we spoke with were satisfied with the service they received. People told us the staff were friendly and helpful. One person said, “They explain everything to you.” Another person said, “I have no problems getting an appointment promptly when I need one.”

There was a complaints procedure in place along with satisfaction surveys. Feedback received from people in surveys was positive about their experience.

We found shortfalls in the practice’s recruitment processes. Not all the staff had criminal records checks which would show if there were any issues which might prevent them from working with vulnerable people. This meant that people who used the service could be at risk because not all necessary checks had been completed